Department of Neurology, Yale University, New Haven, Connecticut, USA.
Center for Neuroepidemiology and Clinical Neurologic Research, Yale, New Haven, Connecticut, USA.
Mov Disord. 2020 Jun;35(6):921-933. doi: 10.1002/mds.28004. Epub 2020 Feb 24.
Parkinson's disease is a common neurodegenerative disorder that presents with nonmotor and motor symptoms. The nonmotor manifestations of Parkinson's disease often begin years before the motor symptoms. Autopsy studies, including both Parkinson's disease patients and matched controls, demonstrated that α-synuclein aggregates in Parkinson's disease patients can be found in both the substantia nigra and the enteric nervous system. Therefore, it has been hypothesized that the pathological process that leads eventually to Parkinson's disease might initially take place in the enteric nervous system years before the appearance of motor features. The gut microbiome plays essential roles in the development and maintenance of different body systems. Dysbiosis of the normal gut microbiome is thought to be associated with pathophysiologic changes not only in the gastrointestinal system itself but also in the enteric and central nervous systems. These changes are thought to ultimately cause loss of dopaminergic neurons via various mechanisms including the release of neurotoxins into the systemic circulation, decreased production of neuroprotective factors, and triggering inflammatory and autoimmune responses. In this review, we review the gut microbiome changes in Parkinson's disease and discuss the mechanisms by which gut microbiome dysbiosis may be a contributing factor to the pathophysiology of Parkinson's disease. © 2020 International Parkinson and Movement Disorder Society.
帕金森病是一种常见的神经退行性疾病，其表现为非运动和运动症状。帕金森病的非运动表现通常在运动症状出现前数年开始。尸检研究包括帕金森病患者和匹配的对照组，表明帕金森病患者的α-突触核蛋白聚集物可在黑质和肠神经系统中找到。因此，有人假设导致帕金森病的病理过程可能最初发生在肠道神经系统中，在运动特征出现前数年。肠道微生物组在不同身体系统的发育和维持中发挥着重要作用。正常肠道微生物组的失调被认为与不仅在胃肠道本身而且在肠和中枢神经系统中发生的病理生理变化有关。这些变化被认为最终通过各种机制导致多巴胺能神经元的丧失，包括神经毒素释放到全身循环中、神经保护因子产生减少以及引发炎症和自身免疫反应。在这篇综述中，我们回顾了帕金森病中的肠道微生物组变化，并讨论了肠道微生物组失调如何可能成为帕金森病病理生理学的一个促成因素。
